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Nekrotisierende Enterokolitis

  • Günter Fasching
  • Johannes Mayr
Chapter

Zusammenfassung

Die nekrotisierende Enterokolitis (NEC) zeigt eine Entzündung und Nekrose der Schleimhaut des Dünn- oder Dickdarms mit nachfolgender Sepsis, in schweren Fällen eine Darmgangrän und -perforation. Es gibt Herz-Kreislauf-bedingte, respiratorische sowie ernährungsbedingte Risikofaktoren. Typisch sind Magenretention, geblähter Bauch, blutige Stühle und kardiorespiratorische Instabilität. Die Diagnose erfolgt mittels Abdomenleerröntgen, Sonographie und Duplex-Sonographie mit Nachweis von Gasbläschen im Pfortadersystem sowie Labor. Primär erfolgt eine parenterale Ernährung und Sepsisbehandlung über einen zentralvenösen Zugang. Operiert wird bei freier Luft im Abdomen und gangränösen Darmabschnitten oder einer gedeckten Perforation sowie bei Verschlechterung trotz maximaler kreislaufunterstützender Therapie. Vorzugsweise werden betroffene Darmabschnitte reseziert und endständige Stomien angelegt. Vor dem Stomaverschluss wird mittels Kontrastmitteldarstellung eine Striktur ausgeschlossen.

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Copyright information

© Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Kinder- und JugendchirurgieKlinikum KlagenfurtKlagenfurt am WörtherseeÖsterreich
  2. 2.Universitäts-Kinderspital beider BaselBaselSchweiz

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